Arrhythmias & electrophysiologyCohort study
Procedural outcomes of transvenous lead extraction in patients with abandoned leads: experience from a large single centre
- Retrospective cohort study
- single-centre
- consecutive patients
Authors' conclusion
Transvenous lead extraction in patients with abandoned leads is characterized by clinical feasibility and effectiveness. However, the presence of abandoned leads is associated with increased procedural complexity, necessitating more frequent utilization of advanced extraction tools.
Study context
- Population
- Consecutive patients undergoing transvenous lead extraction (TLE), January 2013–January 20212,222 leads extracted
- Participants
- 1,109 patients
- Exposure
- TLE in patients with abandoned leads vs active leads only
- Group 1n = 293
- Group 2n = 816reference
- Outcome
- Major complications (primary safety endpoint); clinical success of lead extraction (effectiveness endpoint)
Main finding
As reported in the abstract
No significant difference between groups in major complications (abandoned leads vs active leads only: 2.4 vs. 1.5%)
P = 0.299
No significant difference between groups in clinical success (abandoned leads vs active leads only: 96.2 vs. 97.8%)
P = 0.154
Observational data: associations, not effects.
Further findings
Manual traction success
P < 0.001
Advanced tools or multi-venous approaches required
P < 0.001
Surgical extraction
P = 0.030
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Independent predictors of failure (multivariate) — Dwell time of oldest lead vs Group 2 | 1.15 (1.08–1.21) | P < 0.001 | |
| Independent predictors of failure (multivariate) — Number of leads removed vs Group 2 | 2.04 (1.29–3.21) | P = 0.002 | |
| 0.20.5125Odds ratio (log scale) |
Safety
Emergency thoracotomy
P = 0.019
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Independent predictors of complications (multivariate) — Dwell time of oldest lead vs Group 2 | 1.12 (1.07–1.18) | P < 0.001 | |
| Independent predictors of complications (multivariate) — Number of leads removed vs Group 2 | 1.54 (1.04–2.28) | P = 0.033 | |
| 0.512Odds ratio (log scale) |
Original publication
Summarised from the published abstract; every number is checked against it